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Book Review February 15, 2010

Interviewing Clients Across Cultures: A Practitioner's Guide

Luz M. Guevara-Ramos, MD

J Clin Psychiatry 2010;71(2):213

Article Abstract

From our regular book review column.

Interviewing Clients Across Cultures: A Practitioner’s Guide

Interviewing Clients Across Cultures: A Practitioner’s Guide

by Lisa Aronson Fontes, PhD. The Guilford Press, New York, NY, 2008, 334 pages, $24.00 (paper).

During the past century and into the current one, there has been an increase in awareness of different cultures, as evidenced in literary works as well as in international professional meetings. Lisa Aronson Fontes, PhD, the author of Interviewing Clients Across Cultures: A Practitioner’s Guide, provides specific guidelines for dealing with language competence issues as well as other relevant topics.

Not all individuals of a given country have the same cultural patterns—they may differ as a result of factors such as educational background, social class, and religion. In addition, it must be remembered that communication does change over time.

The author discusses interviewing techniques that can be used across cultures and offers types of questions that seem to be useful for an interview as well as information on nonverbal communications in different countries.

Various close interactions with clients, such as sitting with them at the dinner table, may help the interviewer to observe family interactions. It should be noted that, even within a cultural group, there are individual traits and traditions for each family. The Guide provides brief clinical vignettes throughout the chapters to emphasize such relevant issues.

The author advises readers well: when in doubt as to whether a practice is culturally rooted, consult. She also includes issues that are similarly relevant across cultures and social classes. However, these kinds of issues do change over time with diverse exposure around the world; these patterns are exposed via media such as television, movies, books, and magazines and are distributed around the world. Therefore, professionals should always continue reading about other current cultural patterns and acculturation.

The author also offers advice on diverse issues that are relevant during and after the interview. An important item is the setting of the interview. Clinicians may or may not have the choice in deciding whether to interview at their own, nonneutral locations, such as hospitals or clinics. At times, this question must be bypassed if no immediate alternatives are available.

The meaning of silence during an interview is presented from a general point of view and also from the point of view of various cultural groups. Fontes writes, "Our clients’ ability to keep certain information from us may be one of the few forms of asserting themselves that are available to them. Silence can be a healthy, soul-affirming form of resistance. The people we interview usually have a right to privacy."1(p196)

Taboo topics are well presented and include substance use and child abuse; such topics are stressful for both the caretaker and the interviewer. Although examples are presented, these may change over the years and across social classes. In the past century, for example, children and adolescents did not dare to use profane language. Now, teenagers use this language in daily communications among their peer group and with familiar adults.

The "Interview Reports and Documents" chapter offers useful advice in correctly evaluating, interpreting, and writing the interviewer attitude, goals of the report, possible bias, and recommendations.

The chapter "Beyond Words" discusses nonverbal communication in interviews, commenting on universal aspects that extend across cultures and that appear to be innate, a product of both culture and nature. "Much nonverbal language is immediately understood across cultures, and some of it we even share with primates. In a fascinating example of a gesture employed by chimpanzees and used by many human societies today, chimpanzees greet each other by stretching out a limp hand and offering the back of it to be kissed. A friendly chimp will press its mouth softly against the knuckles of its greeter."1(p82)

 

Chapter 9, "Interviewing Culturally Diverse Children and Adolescents," reviews the issues relevant to interviewing children and adolescents in a general manner. Across cultures, adolescents face their own personal identity crises—a time of questioning authority and exploring possibilities. Nevertheless, an adolescent remains a member of his or her cultural group. Fontes cites the example of a teenager who refuses to take off a baseball cap when asked to do so. She points out that, rather than expressing adolescent rebellion, the teenager may follow a religion that requires male members to cover their heads. In this instance, the teenager has chosen a baseball cap as an unobtrusive way to comply with a religious mandate.1(p204)

At the end of each chapter is a list of questions and recommended readings. These may also be useful for teaching purposes in academic settings. The book includes general guidelines for interacting with members of different cultures. Understanding and addressing reluctance to divulge information is discussed. These topics will continue to expand among the health issues taught in schools. The cross-cultural issues are not easily resolved or understood given that a cultural group is composed of individuals in their own right.

Having participated in a cross-cultural research program adapting interview questions and translating, this reviewer can affirm that conducting interviews with clients across cultures is not an easy task. In Interviewing Clients Across Cultures: A Practitioner’s Guide, Lisa Aronson Fontes discusses the diverse items to be included in the cross-cultural interview. She provides an overview of the issues to be considered in planning the cross-cultural interviews, items to be evaluated, and the reporting process. This overview should be useful for future studies and research initiatives.

Reference

1. Fontes LA. Interviewing Clients Across Cultures: A Practitioner’s Guide. New York, NY: The Guilford Press; 2008.

Luz M. Guevara-Ramos, MD

[email protected]

Author affiliation: University of Puerto Rico School of Medicine, San Juan, Puerto Rico. Potential conflicts of interest: Dr Guevara-Ramos reports no financial or other relationship relevant to the subject of this review.